TY - JOUR
T1 - Global, regional, and national burden of Alzheimer's disease and other dementias, 1990–2016
T2 - a systematic analysis for the Global Burden of Disease Study 2016
AU - GBD 2016 Dementia Collaborators
AU - Nichols, Emma
AU - Szoeke, Cassandra E.I.
AU - Vollset, Stein Emil
AU - Abbasi, Nooshin
AU - Abd-Allah, Foad
AU - Abdela, Jemal
AU - Aichour, Miloud Taki Eddine
AU - Akinyemi, Rufus O.
AU - Alahdab, Fares
AU - Asgedom, Solomon W.
AU - Awasthi, Ashish
AU - Barker-Collo, Suzanne L.
AU - Baune, Bernhard T.
AU - Béjot, Yannick
AU - Belachew, Abate B.
AU - Bennett, Derrick A.
AU - Biadgo, Belete
AU - Bijani, Ali
AU - Bin Sayeed, Muhammad Shahdaat
AU - Brayne, Carol
AU - Carpenter, David O.
AU - Carvalho, Félix
AU - Catalá-López, Ferrán
AU - Cerin, Ester
AU - Choi, Jee Young J.
AU - Dang, Anh Kim
AU - Degefa, Meaza G.
AU - Djalalinia, Shirin
AU - Dubey, Manisha
AU - Duken, Eyasu Ejeta
AU - Edvardsson, David
AU - Endres, Matthias
AU - Eskandarieh, Sharareh
AU - Faro, Andre
AU - Farzadfar, Farshad
AU - Fereshtehnejad, Seyed Mohammad
AU - Fernandes, Eduarda
AU - Filip, Irina
AU - Fischer, Florian
AU - Gebre, Abadi K.
AU - Geremew, Demeke
AU - Ghasemi-Kasman, Maryam
AU - Gnedovskaya, Elena V.
AU - Gupta, Rajeev
AU - Hachinski, Vladimir
AU - Hagos, Tekleberhan B.
AU - Hamidi, Samer
AU - Hankey, Graeme J.
AU - Haro, Josep M.
AU - Hay, Simon I.
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2019/1
Y1 - 2019/1
N2 - Background: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. Methods: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugar-sweetened beverages). Findings: In 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8–51·0), increased from 20.2 million (17·4–23·5) in 1990. This increase of 117% (95% UI 114–121) contrasted with a minor increase in age-standardised prevalence of 1·7% (1·0–2·4), from 701 cases (95% UI 602–815) per 100 000 population in 1990 to 712 cases (614–828) per 100 000 population in 2016. More women than men had dementia in 2016 (27·0 million, 95% UI 23·3–31·4, vs 16.8 million, 14.4–19.6), and dementia was the fifth leading cause of death globally, accounting for 2·4 million (95% UI 2·1–2·8) deaths. Overall, 28·8 million (95% UI 24·5–34·0) DALYs were attributed to dementia; 6·4 million (95% UI 3·4–10·5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. Interpretation: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. Funding: Bill & Melinda Gates Foundation.
AB - Background: The number of individuals living with dementia is increasing, negatively affecting families, communities, and health-care systems around the world. A successful response to these challenges requires an accurate understanding of the dementia disease burden. We aimed to present the first detailed analysis of the global prevalence, mortality, and overall burden of dementia as captured by the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016, and highlight the most important messages for clinicians and neurologists. Methods: GBD 2016 obtained data on dementia from vital registration systems, published scientific literature and surveys, and data from health-service encounters on deaths, excess mortality, prevalence, and incidence from 195 countries and territories from 1990 to 2016, through systematic review and additional data-seeking efforts. To correct for differences in cause of death coding across time and locations, we modelled mortality due to dementia using prevalence data and estimates of excess mortality derived from countries that were most likely to code deaths to dementia relative to prevalence. Data were analysed by standardised methods to estimate deaths, prevalence, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs; computed as the sum of YLLs and YLDs), and the fractions of these metrics that were attributable to four risk factors that met GBD criteria for assessment (high body-mass index [BMI], high fasting plasma glucose, smoking, and a diet high in sugar-sweetened beverages). Findings: In 2016, the global number of individuals who lived with dementia was 43·8 million (95% uncertainty interval [UI] 37·8–51·0), increased from 20.2 million (17·4–23·5) in 1990. This increase of 117% (95% UI 114–121) contrasted with a minor increase in age-standardised prevalence of 1·7% (1·0–2·4), from 701 cases (95% UI 602–815) per 100 000 population in 1990 to 712 cases (614–828) per 100 000 population in 2016. More women than men had dementia in 2016 (27·0 million, 95% UI 23·3–31·4, vs 16.8 million, 14.4–19.6), and dementia was the fifth leading cause of death globally, accounting for 2·4 million (95% UI 2·1–2·8) deaths. Overall, 28·8 million (95% UI 24·5–34·0) DALYs were attributed to dementia; 6·4 million (95% UI 3·4–10·5) of these could be attributed to the modifiable GBD risk factors of high BMI, high fasting plasma glucose, smoking, and a high intake of sugar-sweetened beverages. Interpretation: The global number of people living with dementia more than doubled from 1990 to 2016, mainly due to increases in population ageing and growth. Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases. Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide. Funding: Bill & Melinda Gates Foundation.
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U2 - 10.1016/S1474-4422(18)30403-4
DO - 10.1016/S1474-4422(18)30403-4
M3 - Article
C2 - 30497964
AN - SCOPUS:85058800972
SN - 1474-4422
VL - 18
SP - 88
EP - 106
JO - The Lancet Neurology
JF - The Lancet Neurology
IS - 1
ER -